SAS doctors contract reform

Information on the outcome of negotiations to revise the specialty doctor grade and introduce a new specialist grade.

5 February 2021

New contracts framework agreement - Specialty Doctor and Specialist grade

NHS Wales Employers, the BMA and Welsh Government have been engaged through 2020 in contract negotiations together with colleagues in England and Northern Ireland.

In December 2020, negotiations concluded on two contracts – a new Specialty Doctor contract and a Specialist grade contract – for SAS doctors in England, Wales and Northern Ireland.

Each country is taking forward the agreement through their own Framework Agreements setting out the outcome of the negotiations as they will apply in each country. The Framework Agreement for Wales can be found here.

The key features of the package

  • Multiple-year pay investment of 3% per year over three years to support contract reform.

  • Shorter pay scales to better reward SAS doctors throughout their careers and help reduce the gender pay gap.

  • A new senior grade – Specialist grade – providing a new career framework

  • The extension of plain time to 7am–9pm on weekdays (currently 7am–7pm on weekdays).

  • New safeguards on working pattern frequency to protect SAS doctors and their work-life balance.

  • Increased on-call supplements in line with the model used by consultants in England.

  • Guidance for the introduction of a new SAS advocate role which will be introduced to promote and support SAS doctors’ health and wellbeing.

  • Enhanced pay and provisions for shared parental leave and child bereavement leave.

  • The right to decline elective work in premium time is not a feature of the new contracts.

There are some differences between the contract packages for England, Wales and Northern Ireland and each individual country’s framework agreement sets out the arrangements of the deal.

The multiple year pay deal

The funding investment of 3% per year over three years represents the level of investment being offered for contract reform as a whole, some of which has been focused on making changes to the existing pay scale.

Changes at all points of the SAS pay scales will happen gradually over three years, using temporary transitional pay scales. To reduce from eleven pay points down to five in the Specialty Doctor scale, and to establish three for the Specialist scale, means that the overall level of funding is applied differently to different points on the scale.

Who will be directly affected by the new contracts?

If the new contracts are accepted following the BMA referendum, existing SAS doctors on either the 2008 Specialty Doctor contract, or the closed national 2008 Associate Specialist contract, will be able to exercise an individual choice on whether or not they wish to move to these new contracts.

If the contract is approved, those appointed from 1 April 2021 or anyone who chooses to move employer or takes up a new appointment will be placed in the new contract.

“Trust Grade” or locally employed doctors will not be offered a choice to move to the new contract, however we are committed to exploring how locally employed doctors working in roles which mirror those of the new contracts could be offered the new terms and conditions.

New Specialist grade

A key element of the SAS contract reform is the introduction of a new grade, called the ‘specialist grade’, which will provide an opportunity for career progression for highly experienced specialty doctors. The introduction of this new grade will help to recruit, motivate and retain senior doctors and contribute to SAS grades being a positive and fulfilling career choice.

Stakeholders across the system have contributed to defining the scope of practice of the role, including the roles and responsibilities, how the role differs from existing medical roles and the benefits the new role will offer to doctors, employers and patients.  

The creation of these roles will be driven by local employer need to meet service requirements and will be advertised for competitive entry through local recruitment processes. It is not a regrading process for existing speciality doctors.

A generic capabilities framework for the specialist grade has been developed in partnership between the Academy of Medical Royal Colleges, the British Medical Association and NHS Employers. It outlines the core capabilities and skills expected across all specialties for safe working practices at this senior level. The terms and conditions for the specialist grade state that doctors will need to evidence they meet these criteria in order to successfully enter the grade.

Supporting documents

Generic capabilities framework - outlines the capabilities that a doctor will need to evidence in order to enter the grade and will support employers to create individual person specifications, which will be tailored to the specific requirements of the role. As the overarching framework is generic in content, any specialty-specific, practical or surgical skills that are required will need to be defined in the person specification .

Template job description - to help employers develop a clear description of the requirements for an individual role.

Additional supporting documents to support the implementation of the new arrangements are currently in development and will be published in due course.

Next steps

The BMA are putting the new contract package to a referendum of all BMA and BDA SAS grade members in England, Northern Ireland and Wales which closes on 28 February 2021. The result will be announced as soon as possible following the close of voting on 28 February 2021.